The effectiveness of mHealth interventions for maternal- newborn and child health in low- and middle-income countries: Protocol for a systematic review and meta-analysis

INTRODUCTION: Rates of maternal- newborn and child (MNCH) mortality and morbidity are vastly greater in low- than in high-income countries and represent a major source of global health inequity. A host of systemic- economic- geopolitical and sociocultural factors have been implicated. Mobile information and communication technologies hold potential to ameliorate several of these challenges by supporting coordinated and evidence-based care- facilitating community based health services and enabling citizens to access health information and support. mHealth has attracted considerable attention as a means of supporting maternal- newborn and child health in developing countries and research to assess the impacts of mHealth interventions is increasing. While a number of expert reviews have attempted to summarise this literature- there remains a need for a fully systematic review employing gold standard methods of evidence capture- critical appraisal and meta-analysis- in order to comprehensively map- quality assess and synthesise this body of knowledge. OBJECTIVES: To undertake a systematic review and meta-analysis of studies evaluating the impacts of mobile technology-enabled interventions designed to support maternal- newborn and child health in low- and middle-income countries. METHODS: 16 online international electronic databases of published scientific abstracts and citations will be interrogated for the period 1990 to 2014 (no language restrictions) in order to identify relevant studies. Ongoing/unpublished studies will be identified through searching international trial repositories and consulting experts in the field. Study quality will be assessed using appropriate critical appraisal tools/ including the Cochrane Handbook's 7 evaluation domains for randomised and clinical trials- the Cochrane Effective Practice and Organisation of Care (EPOC) guidelines for other comparative study types- and the Effective Public Health Practice Project (EPHPP) quality assessment tools for observational studies. Blinded assessment by at least two reviewers- with arbitration by a third if necessary- will ensure rigour. Meta-analysis will be undertaken- where possible- using a random-effects model. Sensitivity and subgroup analyses will be reported. Publication bias will be assessed. ETHICS AND DISSEMINATION: Ethical approval is not required. RESULTS: These will be presented in one manuscript. The review protocol is registered with the International Prospective Register for Systematic Reviews (PROSPERO) CRD42014008939.